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Learning Disabilities: Health and Care Services

Volume 757: debated on Wednesday 3 December 2014


Asked by

To ask Her Majesty’s Government, in the light of the report Winterbourne ViewTime for Change, what steps they are taking to address the care of people with a learning disability whose behaviour challenges services.

My Lords, the Government’s report into Winterbourne View included actions for government and partners to provide safe, high-quality care for people with behaviour that challenges. Time for Change acknowledges that the report identified the key steps clearly. We and NHS England will look carefully at the further recommendations in Time for Change.

I thank the Minister for his reply. Providing day-to-day support for people with learning disabilities whose behaviour challenges services is a complex task which requires specialised skills. Given the difference that the Dementia Challenge has made to raising knowledge and skills across the health and social care workforce, and the Prime Minister’s public endorsement of Sir Stephen Bubb’s report last week, will Her Majesty’s Government consider introducing a learning disability challenge, and will the Minister give his personal support to campaigning and encouraging the setting up of such a challenge?

My Lords, that is a very interesting idea; the noble Baroness is right to draw attention to the Dementia Challenge programme, which has been hugely successful. At this point, once we and the system have delivered on our Transforming Care and concordat commitments we will consider how the lessons learnt from the Dementia Challenge programme might be applied in the next programme delivery phase, and indeed in other policy areas as well.

My Lords, I declare an interest as I have a grandson in this position. Is the Minister aware of just how extremely difficult it is to get any action at all in these cases? When someone in their early 20s who is no longer a child has to give up whatever educational establishment they have been at, parents find themselves confronted by a situation where everyone is saying, “Yes, you need mental health services”, but none are available. Do I understand correctly that the suggestion made by the noble Baroness might help that situation? If so, I strongly support it.

My Lords, the report contains a number of important recommendations which we will consider. This report was commissioned by NHS England for NHS England, to make recommendations for a national commissioning framework under which local commissioners would secure community-based support for people with learning disabilities and/or autism. It is an important report, it is right that we take a bit of time to digest it, and, together with NHS England, we are looking carefully to do just that.

My Lords, can the noble Earl clarify something? He knows that NHS England set a target of June 2014 to stop placing people with learning disabilities in inappropriate in-patient facilities. It appears that that has not been followed through by clinical commissioning groups. Can he confirm that, and say whether the Government will discuss with the regulator, the Care Quality Commission, whether a moratorium on the approval of new registrations for inappropriate in-patient facilities will be considered as part of the reforms that need to take place?

The noble Lord is quite right that progress has not been nearly as swift as we, or indeed anyone, would have liked. NHS England has stated its ambition to achieve a 50% reduction in the number of people who were in in-patient beds on 1 April this year by March 2015. Although the latest data for November shows that some 2,600 people were in in-patient settings, the number of people with a transfer date has gone up by more than 1,100 in the last three months, so progress is being made. On CQC registration, the CQC may at any time decline to register or indeed cancel the registration of a provider where it is failing to comply with the registration requirements set out in law. That includes the new duty of candour and the fit and proper persons requirement, which came into effect at the end of last month.

My Lords, in preparing a response to Winterbourne View—Time for Change, will the Minister ensure that the needs of this group of people with learning disabilities and their carers are not confined within a joint commissioning framework, dominated by NHS England and CCGs, but are instead assessed within the provisions of the Care Act so that they benefit fully from the well-being principle, which is a more holistic, social model approach, with good entitlements and safeguards? They must not again be subjected simply to a medical model approach, or the same will happen.

My Lords, the report recommends that the Government should respond to the Bradley report five years on, which deals with how the criminal justice system treats people with learning disabilities and autism. Could the Minister say whether the Government will respond to that report—and, if so, when?

My Lords, the Bradley report, which was a seminal report, was subject to a five-year review earlier this year. We will consider reports of progress and further recommendations in that report in conjunction with the Ministry of Justice, the Home Office and NHS England with regard to future policy development.